PROJECT SUMMARY Healthcare has changed rapidly in the last decade with the widespread use of electronic health records (EHRs) and the creation of national EHR-based data networks that aim to improve the quality of care. The American College of Rheumatology's RISE registry is a federally Qualified Clinical Data Registry that collects EHR data from the practices of almost 1000 rheumatologists nationally, analyzes these data centrally, and continuously feeds back performance on quality measures to practices via a web-based dashboard. In this K24 proposal, the applicant proposes to utilize novel methods in clinical informatics to increase the accuracy of quality measurement, while also developing and testing new EHR-based quality measures relevant to rheumatic diseases. The proposed research will leverage her strong research portfolio, including grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the Agency for Healthcare Research and Quality, her successful track record of achieving national endorsement for EHR-based quality measures, existing data from over 1.4 million patients in the RISE database, and the outstanding institutional environment at the University of California, San Francisco. It will also support her ongoing career development in clinical informatics methods relevant to EHR-based clinical research. For this five year K24 award proposal, she plans to increase the time spent mentoring junior investigators in the field or quality and outcomes measurement in rheumatology, with the goal of helping trainees successfully launch academic research careers in patient- oriented research. Aligned with a comprehensive mentoring plan, the proposal outlines two specific aims, including using natural language processing to increase the accuracy of EHR-based quality measurement in RISE, and developing and validating new, prototype electronic clinical quality measures to monitor and address high impact gaps in care for patients with rheumatic disease. The work will prioritize outcome measures and use eMeasurement standards, including the Quality Data Model and Health Quality Measures Format to develop, specify and test measures. Measures developed through this research and mentoring program will be candidates for nationwide dissemination across rheumatology practices to improve care for individuals with rheumatic disease.